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11939 West River Hills Dr Burnsville MN 55337-1354 | |
(952) 890-4480 | |
(952) 890-4943 |
Full Name | |
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Speciality | Clinic/Center |
Location | 11939 West River Hills Dr, Burnsville, Minnesota |
Authorized Official Name and Position | Maria Jackson (CFO) |
Authorized Official Contact | 4073517080 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2500 Maitland Center Parkway Suite 250 Maitland FL 32751-4174 Ph: (407) 351-7080 | 11939 West River Hills Dr Burnsville MN 55337-1354 Ph: (952) 890-4480 |
NPI Number | 1497961759 |
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Provider Enumeration Date | 05/15/2007 |
Last Update Date | 11/04/2022 |
Certification Date | 11/04/2022 |
Medicare PECOS PAC ID | 0143654749 |
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Medicare Enrollment ID | O20200107000052 |
Identifier | Type | State | Issuer |
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1497961759 | NPI | - | NPPES |
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